The aim of the study is to investigate the correlation between increased bone metabolism in the 3 phase bone scintigraphy (TPBS) and decreased pressure pain thresholds in patients with complex regional pain syndrome (CRPS) of the upper limb and a non-CRPS-group. The investigators assume that there will be a significant correlation between the investigated values in the CRPS-group whereas the non-CRPS-group shows no significant correlation.

Decrease of the pressure pain thresholds of the distal hand joints [ Time Frame: half an hour ] [ Designated as safety issue: No ]

The pressure pain thresholds (PPT) were mesured for the carpus, metacarpophalangeal and proximal interphalangeal joints of both hands. The mean of three determined measurements of each joint was taken as the final value. Subseqently the PPT were compared to the results of the 3 phase bone scintigraphy and the reference data of the healthy subjects.

All Patients with CRPS and limb pain of other origin underwented a 3 phase bone scitigraphy to investigate a possible increased bone metabolism. Phase one and two were recorded within the first five minutes after injection of approximately 500-700 MBq 99mTechnetium-labeled methylene diphosphonate. The third phase was obtained two to three hours after injection.

18 patients with unilateral CPRS of the upper limb were included to the study

Procedure: Pressure Pain measurement

The pressure pain thresholds were established using a manual pressure algometer. The investigated joints were the carpus, the metacarpophalangeal and the proximal interphalangeal joints

Other Name: SOMEDIC Production AB, Sweden, Algometer Type II

Patients with limb pain of other origin

17 patients with unilateral upper limb pain of other origin served as control group

Procedure: Pressure Pain measurement

The pressure pain thresholds were established using a manual pressure algometer. The investigated joints were the carpus, the metacarpophalangeal and the proximal interphalangeal joints

Other Name: SOMEDIC Production AB, Sweden, Algometer Type II

Healthy subjects

18 healthy subjects were included to establish reference data for the pressure pain thresholds

Procedure: Pressure Pain measurement

The pressure pain thresholds were established using a manual pressure algometer. The investigated joints were the carpus, the metacarpophalangeal and the proximal interphalangeal joints

Other Name: SOMEDIC Production AB, Sweden, Algometer Type II

Detailed Description:

Pressure pain of the distal hand joints is a predominant symptom of CRPS. But so far, the diagnostic value of pressure pain in the diagnosis of CRPS has not been investigated. We compared the pressure pain thresholds of the carpus, metacarpophalangeal and proximal interphalangeal joints to a region of interest-based (ROI) analysis of a TBPS in patients with CRPS and patients with limb pain of other origin (non-CRPS-group).Additionally, the PPTs were established for a healthy control group to get reference data.

Eligibility

Ages Eligible for Study:

18 Years and older

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

Yes

Sampling Method:

Non-Probability Sample

Study Population

The study sample consists of three groups:

Patients with CRPS of one of the upper limb type 1 (n=18)

Patients with unilateral upper limb pain of other origin (n=17)

Healthy subjects (n=18)

All patients were recruited from the Department of Pain medicine and the Department of nuclear medicine of the University Hospital Bergmannsheil

Criteria

Inclusion Criteria:

every participant:

aged > 18 years with written informed consent

adequate understanding of the german language

indication for a TPBS independent of the study

Patients with CRPS:

patients with CRPS type 1 of the upper limb diagnosed on the basis of the budapest criteria (Harden, Bruehl et al., 2010)

unilateral pain

Control group:

patients with pain of the upper limbs of other origin than CRPS who underwent a TPBS

unilateral pain

Healthy subjects:

checked by the DFNS IMI questionnaire

Exclusion Criteria:

missing informed consent

inadequate understanding of the german language

disease duration of more than 12 months

other disease of the upper extremity (e.g. polyarthrosis, rheumatoid arthritis)

pregnancy/ lactation period

Contacts and Locations

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To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01623141

Locations

Germany

Bergmannsheil, department for pain management

Bochum, Nordrhein-Westfalen, Germany, 44789

Sponsors and Collaborators

Ruhr University of Bochum

Investigators

Study Director:

Christoph Maier, Prof. Dr.

Head of the pain clinic of the Bergmannsheil University Hospital

More Information

No publications provided

Responsible Party:

Christoph Maier, Prof. Dr. med. (Head of the pain clinic of the Bergmannsheil University Hospital), Ruhr University of Bochum